New prostate cancer radiotherapy regime could save NHS millions

The National Health Service could save tens of millions of pounds by switching to a new radiotherapy regime for patients with prostate cancer, suggest findings of a major clinical trial presented at the National Cancer Research Institute Cancer Conference in Liverpool this week.

According to the CHHiP study, led by researchers at the NCRI and Royal Marsden NHS Foundation Trust and funded by Cancer Research UK, using a modern type of radiotherapy in higher doses over fewer hospital visits than is currently recommended on the NHS is as effective in delaying disease progression, cheaper and more convenient for patients.

Daily treatment given in higher doses over 20 days as opposed to lower doses over current 37 days would lead to a reduction nationally of more than 150,000 hospital visits per year, the researchers said, while the regime also did not increase the rate of side effects.

“From a logistical and patient convenience point of view, being able to treat patients over a shorter period of time has been a goal for specialists, but the question has always been whether it was safe to do so. This study shows that it is safe and effective, and there should be no reason why this cannot be implemented immediately - it is saving the NHS resources”.

Abiraterone resistance blood test

Meanwhile, scientists from the Institute for Cancer Research, The Royal Marsden, and the University of Trento, Italy, have developed a blood test that can identify key mutations behind resistance to a popular prostate cancer drug, and identify patients unlikely to respond to treatment.

Analysing 274 blood samples from 97 patients with DNA sequencing techniques, the researchers found that mutations in a gene called the androgen receptor predicted resistance to abiraterone, and that these mutations led to poorer survival.

Abiraterone is the standard therapy for men with advanced prostate cancer, but 30%-60% of patients don’t respond to treatment. The study’s findings should help personalise treatment with the drug without the need for a biopsy, so that only those who will benefit receive it.

“We are now planning a clinical trial involving up to 600 men in which we aim to prospectively show that men who are positive with our test have significantly greater benefit from chemotherapy in preference to abiraterone or similar drugs,” said Gerhardt Attard, clinician scientist at The ICR and consultant medical oncologist at The Royal Marsden.

“Critically, we believe that this sort of technology would be relatively straightforward to implement in NHS hospitals, making it accessible to a large number of patients,” he noted.